Matter of M.B., 8 N.Y.3d 436 (2007)
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The Health Care Decisions Act for Persons with Mental Retardation (HCDA) grants guardians, including those appointed before the Act’s effective date, the authority to make health care decisions, including end-of-life decisions, for mentally retarded individuals, subject to specific procedural safeguards.
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Summary
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This case addresses whether the HCDA, which allows guardians to make health care decisions (including end-of-life decisions) for mentally retarded persons, applies only to guardians appointed after the Act’s effective date. The Court of Appeals held that the HCDA also extends such authority to guardians appointed before the Act, provided they comply with the statute’s procedural requirements. The Court emphasized the legislative intent to clarify existing guardian powers and the importance of protecting the best interests of mentally retarded individuals.
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Facts
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M.B., a 42-year-old man with Down syndrome, was profoundly mentally retarded and never had the capacity to make healthcare decisions. His brother, R.B., was appointed his guardian in January 2003, before the HCDA’s effective date. M.B. became terminally ill and was on life support. R.B. requested the respirator be disconnected, consistent with medical advice. The Mental Hygiene Legal Service (MHLS) objected, arguing R.B. lacked the authority because he was appointed before the HCDA.
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Procedural History
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The Surrogate’s Court initially rejected MHLS’ objection, authorizing the cessation of life-sustaining treatment. M.B. was removed from the respirator and died. MHLS appealed, and the Appellate Division reversed, holding the HCDA did not extend end-of-life decision-making powers to pre-existing guardians. The Court of Appeals granted leave to appeal.
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Issue(s)
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Whether the Health Care Decisions Act for Persons with Mental Retardation grants guardians appointed before the Act’s effective date the authority to make health care decisions, including decisions to withdraw or withhold life-sustaining treatment, for their mentally retarded wards, without a separate court order specifically expanding their guardianship powers.
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Holding
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Yes, because the Legislature intended to extend to all guardians, regardless of appointment date, the power to request the termination of life-sustaining treatment under the new procedures set forth in SCPA 1750-b.
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Court’s Reasoning
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The Court focused on the statutory text and legislative intent. SCPA 1750(2) states that the absence of a capacity determination for guardians appointed before the HCDA’s effective date does not preclude them from making health care decisions. SCPA 1750-b(1) states that guardians